department of pathology
The respiratory
system disease
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
Acute bronchitis
department of pathology
Chronic bronchitis --- mucous gland proliferation
department of pathology
Chronic bronchitis --- inflammatory cell infiltrating
department of pathology
Chronic bronchitis --- squamous metaplasia
department of pathology
Chronic bronchitis
department of pathology
Chronic bronchitis --- small airway
department of pathology
Chronic bronchitis --- small airway
department of pathology
department of pathology
Chronic bronchitis --- small airway
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
department of pathology
emphysema
department of pathology
department of pathology
department of pathology
“Smoking, lung
department of pathology
emphysema
department of pathology
Chronic
bronchitis
Pulmonary
emphysema
department of pathology
department of pathology
capillary vessel pressured
capillary vessels decrease
pulmonary hypertension
right ventricular
hypertrophy
Cor pulmonale
(Pulmonary heart disease)
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
? Chronic cor pulmonale
can be any of the diseases
? The most common cause is
chronic obstructive lung
disease.
department of pathology
? Morphology is characterized
by right ventricular,and often
right atria,hypertrophy（ up to
1cm or more）,
? The thickness of the right
ventricular wall may exceed
that of the left ventricle.
department of pathology
department of pathology
Cor pulmonale
department of pathology
Cor pulmonale
department of pathology
Diagnosis
> 5mm
department of pathology
Diagnosis?
department of pathology
Cases,Discussion and pathological diagnosis
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
pneumonia
alveolus
interstitium
Lobar
pneumonia
Lobular
pneumonia
Bacterial
pneumonia
viral
pneumonia
Fungal
pneumonia
department of pathology
alveolus
Lobar
pneumonia
Lobular
pneumonia
Bacterial
pneumonia
Legionella
pneumonia
interstitium(bronchiole)
department of pathology
department of pathology
Lobar pneumonia
? Etiological factor
pneumococci (95%)
? location (anatomic distribution)
lobar
? Basic change
acute fibrinous inflammation
department of pathology
Clinical features
? adult,sudden
? malaise,shaking chills
? fever ( up to 40 or 41 ° C )
? cough,slightly turbid,watery
sputum,frankly purulent,
hemorrhage,“rusty” sputum
? shortness of breath,orthopnea,
cyanosis
department of pathology
morphology
department of pathology
Four stages
? stage of congestion
? stage of red hepatization
? stage of gray hepatization
? stage of resolution
department of pathology
stage of red hepatizationstage of gray hepatization
department of pathology
stage of red hepatization
department of pathology
stage of red hepatization
department of pathology
stage of gray hepatization
department of pathology
stage of gray hepatization
department of pathology
stage of gray hepatization
department of pathology
stage of gray hepatization
department of pathology
Organization of
lobar pneumonia
department of pathology
Lobular pneumonia
(bronchopneumonia)
? Etiological factor
bacteria ( pyogenic organisms )
? location (anatomic distribution)
lobular( bronchiole + alveolar)
? Basic change
acute suppurative inflammation
department of pathology
Clinical features
? elderly and child,malnutrition
? fever ( up to 38 ° or 39.5° C )
? cough,expectoration,
department of pathology
morphology
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
department of pathology
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
department of pathology
interstitial pneumonia
( Primary atypical pneumonia )
Anatomic distribution
Pulmonary interstitial inflammation
Etiologic agent
virus and mycoplasm ( the most )
department of pathology
? The clinical course is varied depending
on the extent and severity of the disease.
? Histology shows interstitial
inflammation consisting of lymphocytes,
macrophages and plasma cell.
? The alveoli may be relatively free of
cellular exudate.
department of pathology
morphology
department of pathology
department of pathology
Here is the microscopic appearance of a viral pneumonia with interstitial
lymphocytic infiltrates,Note that there is no alveolar exudate,
department of pathology
Interstitial pneumonia
department of pathology
Viral pneumonia with hemorrhage
department of pathology
Viral pneumonia
department of pathology
department of pathology
Mycoplasma pneumonia
department of pathology
Mycoplasma pneumonia
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
Silicates are inorganic minerals
abundant in stone and sand.
Any industrial worker involved in
the grinding of stone or sand will
be at risk from silicosis.
Silicosis is the occupational disease.
department of pathology
?Etiological factor
silica less than 2μm in diameter
small particles enter the terminal
respiratory units where they are
ingested by alveolar macrophages
fibrosis + nodules
department of pathology
Basic change
? diffuse pulmonary fibrosis
? numerous silicotic nodules
department of pathology
department of pathology
department of pathology
department of pathology
Diffuse interstitial fibrosis
department of pathology
Diffuse interstitial fibrosis
department of pathology
Stage
Ⅰ stage --- silicotic nodules in hilar
lymph node
Ⅱ stage --- silicotic nodules in lungs,
changes less than 1/3 lung
Ⅲ stage --- silicotic nodule more
than 2cm
department of pathology
Complications
1,Tuberculosis and silicotuberculosis
2,Chromic cor pulmonale
3,Infection of lung and chromic
obstructive emphysema
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
Nasopharyngeal
carcinoma
department of pathology
This carcinoma was one of the
earliest cancers linked to a prior viral
infection,Epstein-Barr Virus (EBV),
This carcinoma accounts for over
50% of all malignancies in China,
but accounts for only 2% of
malignancies in the United States,
department of pathology
department of pathology
department of pathology
department of pathology
department of pathology
Histological classification
? Squamous cell carcinoma
differentiated
undifferentiated
? Adenocarcinoma
department of pathology
Normal Nasopharyngeal epithelium
department of pathology
Vesicularnucleus carcinoma
department of pathology
Vesicularnucleus
carcinoma
department of pathology
Spread and metastasis
1.Direct spreading
2.Lymphatic metastasis
3.Hematogenous metastasis
department of pathology
department of pathology
Primary cancer of the lung
? Most common primary malignant tumour
? Directly related to cigarette smoking
? Associated with occupational exposure to
carcinogens
? Overall 5-year survival rate of 4-7%
? Squamous cell,small cell,adenocarcinoma,
and large cell undifferentiated types
department of pathology
morphology
department of pathology
This is a squamous cell
carcinoma of the lung that
is arising centrally in the
lung,
department of pathology
department of pathology
This tumor
arise near
the hilus of
the lung,
department of pathology
department of pathology
department of pathology
Diffuse type lung carcinoma Metastasic carcinoma
department of pathology
This is a peripheral
adenocarcinoma of the
lung,
Adenocarcinomas and
large cell anaplastic
carcinomas tend to
occur more peripherally
in lung,
The solitary appearance
of this neoplasm
suggests that the tumor
is primary rather than
metastatic.
department of pathology
Histological classification
? Nor small cell lung carcinoma(NSCLC)
Squamous cell carcinoma(50-60%)
adenocarcinoma(13-15%)
Large cell carcinoma(15-20%)
? Small cell lung carcinoma(SCLC)
“oat cell carcinoma”(10-20%)
department of pathology
Squamous cell carcinoma of lung
department of pathology
department of pathology
Oat cell carcinoma of lung
department of pathology
Spread and metastasis
1.Direct spreading
2.Lymphatic metastasis
3.Hematogenous metastasis
department of pathology
This is sqamous cell carcinoma that extends from hilum to pleura,
department of pathology
department of pathology
Lymphatic metastasis
department of pathology
department of pathology
department of pathology
department of pathology
department of pathology
department of pathology
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
Chronic bronchitis --- inflammatory cell infiltrating
department of pathology
“Smoking, lung
department of pathology
emphysema
department of pathology
Chronic
bronchitis
Pulmonary
emphysema
department of pathology
capillary vessel pressured
capillary vessels decrease
pulmonary hypertension
right ventricular
hypertrophy
Cor pulmonale
(Pulmonary heart disease)
department of pathology
pneumonia
alveolus
interstitium
Lobar
pneumonia
Lobular
pneumonia
Bacterial
pneumonia
viral
pneumonia
Fungal
pneumonia
department of pathology
alveolus
Lobar
pneumonia
Lobular
pneumonia
Bacterial
pneumonia
Legionella
pneumonia
interstitium(bronchiole)
department of pathology
department of pathology
Lobar
pneumonia
department of pathology
? Etiological factor
pneumococci (95%)
? location (anatomic distribution)
lobar
? Basic change
acute fibrinous inflammation
department of pathology
Clinical features
? adult,sudden
? malaise,shaking chills
? fever ( up to 40 or 41 ° C )
? cough,slightly turbid,watery
sputum,frankly purulent,
hemorrhage,“rusty” sputum
? shortness of breath,orthopnea,
cyanosis
department of pathology
stage of red hepatizationstage of gray hepatization
department of pathology
stage of red hepatization
department of pathology
stage of gray hepatization
department of pathology
stage of gray hepatization
department of pathology
Organization of
lobar pneumonia
department of pathology
Lobular pneumonia
(bronchopneumonia)
department of pathology
? Etiological factor
bacteria ( pyogenic organisms )
? location (anatomic distribution)
lobular( bronchiole + alveolar)
? Basic change
acute suppurative inflammation
department of pathology
Clinical features
? elderly and child,malnutrition
? fever ( up to 38 ° or 39.5° C )
? cough,expectoration,
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
interstitial pneumonia
( Primary atypical
pneumonia )
department of pathology
Anatomic distribution
Pulmonary interstitial inflammation
Etiologic agent
virus and mycoplasm ( the most )
department of pathology
? The clinical course is varied depending
on the extent and severity of the disease.
? Histology shows interstitial
inflammation consisting of lymphocytes,
macrophages and plasma cell.
? The alveoli may be relatively free of
cellular exudate.
department of pathology
Here is the microscopic appearance of a viral pneumonia with interstitial
lymphocytic infiltrates,Note that there is no alveolar exudate,
department of pathology
silicosis
department of pathology
Silicates are inorganic minerals
abundant in stone and sand.
Any industrial worker involved in
the grinding of stone or sand will
be at risk from silicosis.
Silicosis is the occupational disease.
department of pathology
?Etiological factor
silica less than 2μm in diameter
small particles enter the terminal
respiratory units where they are
ingested by alveolar macrophages
fibrosis + nodules
department of pathology
Basic change
? diffuse pulmonary fibrosis
? numerous silicotic nodules
department of pathology
department of pathology
department of pathology
Diffuse interstitial fibrosis
department of pathology
Stage
Ⅰ stage --- silicotic nodules in hilar
lymph node
Ⅱ stage --- silicotic nodules in lungs,
changes less than 1/3 lung
Ⅲ stage --- silicotic nodule more
than 2cm
department of pathology
Complications
1,Tuberculosis and silicotuberculosis
2,Chromic cor pulmonale
3,Infection of lung and chromic
obstructive emphysema
department of pathology
Nasopharyngeal
carcinoma
department of pathology
This carcinoma was one of the
earliest cancers linked to a prior viral
infection,Epstein-Barr Virus (EBV),
This carcinoma accounts for over
50% of all malignancies in China,
but accounts for only 2% of
malignancies in the United States,
department of pathology
department of pathology
department of pathology
department of pathology
Histological classification
? Squamous cell carcinoma
differentiated
undifferentiated
? Adenocarcinoma
department of pathology
Vesicularnucleus carcinoma
department of pathology
Spread and metastasis
1.Direct spreading
2.Lymphatic metastasis
3.Hematogenous metastasis
department of pathology
Primary cancer of
the lung
department of pathology
? Most common primary malignant tumour
? Directly related to cigarette smoking
? Associated with occupational exposure to
carcinogens
? Overall 5-year survival rate of 4-7%
? Squamous cell,small cell,adenocarcinoma,
and large cell undifferentiated types
department of pathology
department of pathology
department of pathology
Diffuse type lung carcinoma Metastasic carcinoma
department of pathology
This is a peripheral
adenocarcinoma of the
lung,
Adenocarcinomas and
large cell anaplastic
carcinomas tend to
occur more peripherally
in lung,
The solitary appearance
of this neoplasm
suggests that the tumor
is primary rather than
metastatic.
department of pathology
Histological classification
? Nor small cell lung carcinoma(NSCLC)
Squamous cell carcinoma(50-60%)
adenocarcinoma(13-15%)
Large cell carcinoma(15-20%)
? Small cell lung carcinoma(SCLC)
“oat cell carcinoma”(10-20%)
department of pathology
Squamous cell carcinoma of lung
department of pathology
department of pathology
Oat cell carcinoma of lung
department of pathology
Spread and metastasis
1.Direct spreading
2.Lymphatic metastasis
3.Hematogenous metastasis
department of pathology
This is sqamous cell carcinoma that extends from hilum to pleura,
department of pathology
department of pathology
Lymphatic metastasis
department of pathology
department of pathology
department of pathology
Liulijiang@netease.com
Liulijiang@163.com
department of pathology
The respiratory
system disease
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
Acute bronchitis
department of pathology
Chronic bronchitis --- mucous gland proliferation
department of pathology
Chronic bronchitis --- inflammatory cell infiltrating
department of pathology
Chronic bronchitis --- squamous metaplasia
department of pathology
Chronic bronchitis
department of pathology
Chronic bronchitis --- small airway
department of pathology
Chronic bronchitis --- small airway
department of pathology
department of pathology
Chronic bronchitis --- small airway
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
department of pathology
emphysema
department of pathology
department of pathology
department of pathology
“Smoking, lung
department of pathology
emphysema
department of pathology
Chronic
bronchitis
Pulmonary
emphysema
department of pathology
department of pathology
capillary vessel pressured
capillary vessels decrease
pulmonary hypertension
right ventricular
hypertrophy
Cor pulmonale
(Pulmonary heart disease)
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
? Chronic cor pulmonale
can be any of the diseases
? The most common cause is
chronic obstructive lung
disease.
department of pathology
? Morphology is characterized
by right ventricular,and often
right atria,hypertrophy（ up to
1cm or more）,
? The thickness of the right
ventricular wall may exceed
that of the left ventricle.
department of pathology
department of pathology
Cor pulmonale
department of pathology
Cor pulmonale
department of pathology
Diagnosis
> 5mm
department of pathology
Diagnosis?
department of pathology
Cases,Discussion and pathological diagnosis
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
pneumonia
alveolus
interstitium
Lobar
pneumonia
Lobular
pneumonia
Bacterial
pneumonia
viral
pneumonia
Fungal
pneumonia
department of pathology
alveolus
Lobar
pneumonia
Lobular
pneumonia
Bacterial
pneumonia
Legionella
pneumonia
interstitium(bronchiole)
department of pathology
department of pathology
Lobar pneumonia
? Etiological factor
pneumococci (95%)
? location (anatomic distribution)
lobar
? Basic change
acute fibrinous inflammation
department of pathology
Clinical features
? adult,sudden
? malaise,shaking chills
? fever ( up to 40 or 41 ° C )
? cough,slightly turbid,watery
sputum,frankly purulent,
hemorrhage,“rusty” sputum
? shortness of breath,orthopnea,
cyanosis
department of pathology
morphology
department of pathology
Four stages
? stage of congestion
? stage of red hepatization
? stage of gray hepatization
? stage of resolution
department of pathology
stage of red hepatizationstage of gray hepatization
department of pathology
stage of red hepatization
department of pathology
stage of red hepatization
department of pathology
stage of gray hepatization
department of pathology
stage of gray hepatization
department of pathology
stage of gray hepatization
department of pathology
stage of gray hepatization
department of pathology
Organization of
lobar pneumonia
department of pathology
Lobular pneumonia
(bronchopneumonia)
? Etiological factor
bacteria ( pyogenic organisms )
? location (anatomic distribution)
lobular( bronchiole + alveolar)
? Basic change
acute suppurative inflammation
department of pathology
Clinical features
? elderly and child,malnutrition
? fever ( up to 38 ° or 39.5° C )
? cough,expectoration,
department of pathology
morphology
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
department of pathology
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
department of pathology
interstitial pneumonia
( Primary atypical pneumonia )
Anatomic distribution
Pulmonary interstitial inflammation
Etiologic agent
virus and mycoplasm ( the most )
department of pathology
? The clinical course is varied depending
on the extent and severity of the disease.
? Histology shows interstitial
inflammation consisting of lymphocytes,
macrophages and plasma cell.
? The alveoli may be relatively free of
cellular exudate.
department of pathology
morphology
department of pathology
department of pathology
Here is the microscopic appearance of a viral pneumonia with interstitial
lymphocytic infiltrates,Note that there is no alveolar exudate,
department of pathology
Interstitial pneumonia
department of pathology
Viral pneumonia with hemorrhage
department of pathology
Viral pneumonia
department of pathology
department of pathology
Mycoplasma pneumonia
department of pathology
Mycoplasma pneumonia
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
Silicates are inorganic minerals
abundant in stone and sand.
Any industrial worker involved in
the grinding of stone or sand will
be at risk from silicosis.
Silicosis is the occupational disease.
department of pathology
?Etiological factor
silica less than 2μm in diameter
small particles enter the terminal
respiratory units where they are
ingested by alveolar macrophages
fibrosis + nodules
department of pathology
Basic change
? diffuse pulmonary fibrosis
? numerous silicotic nodules
department of pathology
department of pathology
department of pathology
department of pathology
Diffuse interstitial fibrosis
department of pathology
Diffuse interstitial fibrosis
department of pathology
Stage
Ⅰ stage --- silicotic nodules in hilar
lymph node
Ⅱ stage --- silicotic nodules in lungs,
changes less than 1/3 lung
Ⅲ stage --- silicotic nodule more
than 2cm
department of pathology
Complications
1,Tuberculosis and silicotuberculosis
2,Chromic cor pulmonale
3,Infection of lung and chromic
obstructive emphysema
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
Nasopharyngeal
carcinoma
department of pathology
This carcinoma was one of the
earliest cancers linked to a prior viral
infection,Epstein-Barr Virus (EBV),
This carcinoma accounts for over
50% of all malignancies in China,
but accounts for only 2% of
malignancies in the United States,
department of pathology
department of pathology
department of pathology
department of pathology
department of pathology
Histological classification
? Squamous cell carcinoma
differentiated
undifferentiated
? Adenocarcinoma
department of pathology
Normal Nasopharyngeal epithelium
department of pathology
Vesicularnucleus carcinoma
department of pathology
Vesicularnucleus
carcinoma
department of pathology
Spread and metastasis
1.Direct spreading
2.Lymphatic metastasis
3.Hematogenous metastasis
department of pathology
department of pathology
Primary cancer of the lung
? Most common primary malignant tumour
? Directly related to cigarette smoking
? Associated with occupational exposure to
carcinogens
? Overall 5-year survival rate of 4-7%
? Squamous cell,small cell,adenocarcinoma,
and large cell undifferentiated types
department of pathology
morphology
department of pathology
This is a squamous cell
carcinoma of the lung that
is arising centrally in the
lung,
department of pathology
department of pathology
This tumor
arise near
the hilus of
the lung,
department of pathology
department of pathology
department of pathology
Diffuse type lung carcinoma Metastasic carcinoma
department of pathology
This is a peripheral
adenocarcinoma of the
lung,
Adenocarcinomas and
large cell anaplastic
carcinomas tend to
occur more peripherally
in lung,
The solitary appearance
of this neoplasm
suggests that the tumor
is primary rather than
metastatic.
department of pathology
Histological classification
? Nor small cell lung carcinoma(NSCLC)
Squamous cell carcinoma(50-60%)
adenocarcinoma(13-15%)
Large cell carcinoma(15-20%)
? Small cell lung carcinoma(SCLC)
“oat cell carcinoma”(10-20%)
department of pathology
Squamous cell carcinoma of lung
department of pathology
department of pathology
Oat cell carcinoma of lung
department of pathology
Spread and metastasis
1.Direct spreading
2.Lymphatic metastasis
3.Hematogenous metastasis
department of pathology
This is sqamous cell carcinoma that extends from hilum to pleura,
department of pathology
department of pathology
Lymphatic metastasis
department of pathology
department of pathology
department of pathology
department of pathology
department of pathology
department of pathology
department of pathology
Nasopharyngeal
carcinoma
Chronic bronchitis
Chronic constructive
emphysema
Pneumonia
Silicosis
Cancer of the lung
Chronic cor pulmonale
department of pathology
Chronic bronchitis
obstructive emphysema
Chronic cor pulmonale
department of pathology
Chronic bronchitis --- inflammatory cell infiltrating
department of pathology
“Smoking, lung
department of pathology
emphysema
department of pathology
Chronic
bronchitis
Pulmonary
emphysema
department of pathology
capillary vessel pressured
capillary vessels decrease
pulmonary hypertension
right ventricular
hypertrophy
Cor pulmonale
(Pulmonary heart disease)
department of pathology
pneumonia
alveolus
interstitium
Lobar
pneumonia
Lobular
pneumonia
Bacterial
pneumonia
viral
pneumonia
Fungal
pneumonia
department of pathology
alveolus
Lobar
pneumonia
Lobular
pneumonia
Bacterial
pneumonia
Legionella
pneumonia
interstitium(bronchiole)
department of pathology
department of pathology
Lobar
pneumonia
department of pathology
? Etiological factor
pneumococci (95%)
? location (anatomic distribution)
lobar
? Basic change
acute fibrinous inflammation
department of pathology
Clinical features
? adult,sudden
? malaise,shaking chills
? fever ( up to 40 or 41 ° C )
? cough,slightly turbid,watery
sputum,frankly purulent,
hemorrhage,“rusty” sputum
? shortness of breath,orthopnea,
cyanosis
department of pathology
stage of red hepatizationstage of gray hepatization
department of pathology
stage of red hepatization
department of pathology
stage of gray hepatization
department of pathology
stage of gray hepatization
department of pathology
Organization of
lobar pneumonia
department of pathology
Lobular pneumonia
(bronchopneumonia)
department of pathology
? Etiological factor
bacteria ( pyogenic organisms )
? location (anatomic distribution)
lobular( bronchiole + alveolar)
? Basic change
acute suppurative inflammation
department of pathology
Clinical features
? elderly and child,malnutrition
? fever ( up to 38 ° or 39.5° C )
? cough,expectoration,
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
bronchopneumonia
department of pathology
interstitial pneumonia
( Primary atypical
pneumonia )
department of pathology
Anatomic distribution
Pulmonary interstitial inflammation
Etiologic agent
virus and mycoplasm ( the most )
department of pathology
? The clinical course is varied depending
on the extent and severity of the disease.
? Histology shows interstitial
inflammation consisting of lymphocytes,
macrophages and plasma cell.
? The alveoli may be relatively free of
cellular exudate.
department of pathology
Here is the microscopic appearance of a viral pneumonia with interstitial
lymphocytic infiltrates,Note that there is no alveolar exudate,
department of pathology
silicosis
department of pathology
Silicates are inorganic minerals
abundant in stone and sand.
Any industrial worker involved in
the grinding of stone or sand will
be at risk from silicosis.
Silicosis is the occupational disease.
department of pathology
?Etiological factor
silica less than 2μm in diameter
small particles enter the terminal
respiratory units where they are
ingested by alveolar macrophages
fibrosis + nodules
department of pathology
Basic change
? diffuse pulmonary fibrosis
? numerous silicotic nodules
department of pathology
department of pathology
department of pathology
Diffuse interstitial fibrosis
department of pathology
Stage
Ⅰ stage --- silicotic nodules in hilar
lymph node
Ⅱ stage --- silicotic nodules in lungs,
changes less than 1/3 lung
Ⅲ stage --- silicotic nodule more
than 2cm
department of pathology
Complications
1,Tuberculosis and silicotuberculosis
2,Chromic cor pulmonale
3,Infection of lung and chromic
obstructive emphysema
department of pathology
Nasopharyngeal
carcinoma
department of pathology
This carcinoma was one of the
earliest cancers linked to a prior viral
infection,Epstein-Barr Virus (EBV),
This carcinoma accounts for over
50% of all malignancies in China,
but accounts for only 2% of
malignancies in the United States,
department of pathology
department of pathology
department of pathology
department of pathology
Histological classification
? Squamous cell carcinoma
differentiated
undifferentiated
? Adenocarcinoma
department of pathology
Vesicularnucleus carcinoma
department of pathology
Spread and metastasis
1.Direct spreading
2.Lymphatic metastasis
3.Hematogenous metastasis
department of pathology
Primary cancer of
the lung
department of pathology
? Most common primary malignant tumour
? Directly related to cigarette smoking
? Associated with occupational exposure to
carcinogens
? Overall 5-year survival rate of 4-7%
? Squamous cell,small cell,adenocarcinoma,
and large cell undifferentiated types
department of pathology
department of pathology
department of pathology
Diffuse type lung carcinoma Metastasic carcinoma
department of pathology
This is a peripheral
adenocarcinoma of the
lung,
Adenocarcinomas and
large cell anaplastic
carcinomas tend to
occur more peripherally
in lung,
The solitary appearance
of this neoplasm
suggests that the tumor
is primary rather than
metastatic.
department of pathology
Histological classification
? Nor small cell lung carcinoma(NSCLC)
Squamous cell carcinoma(50-60%)
adenocarcinoma(13-15%)
Large cell carcinoma(15-20%)
? Small cell lung carcinoma(SCLC)
“oat cell carcinoma”(10-20%)
department of pathology
Squamous cell carcinoma of lung
department of pathology
department of pathology
Oat cell carcinoma of lung
department of pathology
Spread and metastasis
1.Direct spreading
2.Lymphatic metastasis
3.Hematogenous metastasis
department of pathology
This is sqamous cell carcinoma that extends from hilum to pleura,
department of pathology
department of pathology
Lymphatic metastasis
department of pathology
department of pathology
department of pathology
Liulijiang@netease.com
Liulijiang@163.com
department of pathology
